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Clinical Benefit of Treatment of Stage-1, Low-Risk Hypertension : Korean National Health Insurance Database Analysis

Authors
 Chan Joo Lee  ;  Jiin Ryu  ;  Hyeon-Chang Kim  ;  Dong-Ryeol Ryu  ;  Sang-Hyun Ihm  ;  Yong-Jin Kim  ;  Jin-Ho Shin  ;  Wook Bum Pyun  ;  Hyoung-Soo Kang  ;  Jong-Heon Park  ;  Jinseub Hwang  ;  Sungha Park 
Citation
 Hypertension, Vol.72(6) : 1285-1293, 2018 
Journal Title
 Hypertension 
ISSN
 0194-911X 
Issue Date
2018
Keywords
blood pressure ; hypertension ; mortality ; myocardial infarction ; stroke
Abstract
Evidence about the benefits of treating uncomplicated, low-risk, stage-1 hypertension is lacking. The study aimed to investigate the association between mean blood pressure (BP) and clinical outcomes, and to determine optimal BPs in treated, low-risk, stage-1 hypertension. From the National Health Insurance Service Health Examination Database, patients with stage-1 hypertension between 2005 and 2006 were selected. They had a systolic BP of 140 to 159 mm Hg or diastolic BP of 90 to 99 mm Hg. Patients were grouped as controlled (mean BP <140/90 mm Hg; n=99 301) and uncontrolled (mean BP ≥140/90 mm Hg; n=49 460) according to their mean BP recorded during the follow-up health examination. All-cause mortality and cardiovascular outcomes were examined. Mean BPs in the controlled and uncontrolled groups were 131.1/80.9 and 144.6/86.8 mm Hg, respectively. Controlled BP was associated with significantly lower risks of all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease. Subgroup analysis demonstrated benefits of controlled BP in hypertensive patients aged <50 years for all-cause mortality, all stroke, hemorrhagic stroke, ischemic stroke, and end-stage renal disease, with no significant interaction according to age. The BP associated with the lowest risk of all-cause mortality was 120 to <130 mm Hg (systolic BP) and 70 to <80 mm Hg (diastolic BP). There was an increased risk of myocardial infarction in patients with mean systolic BP <120 mm Hg and diastolic BP <80 mm Hg. BP <140/90 mm Hg was associated with a significant reduction in the risk of mortality, stroke, and end-stage renal disease, with the lowest mortality risk at BP ranges of 120 to <130 and 70 to <80 mm Hg.
Full Text
https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.118.11787
DOI
10.1161/HYPERTENSIONAHA.118.11787
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김현창(Kim, Hyeon Chang) ORCID logo https://orcid.org/0000-0001-7867-1240
박성하(Park, Sung Ha) ORCID logo https://orcid.org/0000-0001-5362-478X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166636
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